在老年人处方和药物优化中的信息学工具:在高可靠性组织中开发和传播VIONE方法
Shira G Winter1, Christopher Sedgwick2, Ashleigh Wallace-Lacey3
1Icahn School of Medicine at Mount Sinai, New York, New York, USA.
在退伍军人卫生管理局内,VIONE减药方法成功地减少了老年人潜在不合适的药物 (PIMs). 这种全系统采用通过信息化工具提高了药物质量和患者安全.
科学领域:
- 老年医学 老年医学
- 医疗信息学 医疗信息学
- 临床药房 临床药房
背景情况:
- 多药在老年人中很普遍,增加了潜在不合适药物 (PIM) 的不良事件风险.
- 降低处方方法可以提高药物使用质量,但面临实施挑战.
- 退伍军人卫生管理局 (VHA) 开发了VIONE方法来解决这些问题.
研究的目的:
- 描述VIONE药物止处方方法的实施工具和仪表板.
- 检查VIONE在VHA内部的采用和维持情况,这是一个高度可靠的组织.
- 评估VIONE对减少老年人多药和PIMs的影响.
主要方法:
- VIONE通过VHA的卓越传播倡议进行了传播.
- 创建了一个实施工具包和四个基于电子医疗记录的仪表板.
- 仪表板监测了VIONE的使用情况,药物停用情况,并确定了抑郁症候选人.
主要成果:
- 自2016年以来,VIONE在>130个VHA医疗中心被采用.
- 影响了近70万个独特的患者.
- 超过15000家供应商停止提供超过160万份药品订单.
结论:
- 在全国范围内成功实施和维持了VIONE方法论和信息化工具.
- 导致减少PIM使用,改善药物质量,并提高老年人患者的安全性.
- 未来的努力应该利用信息技术来定制临床决策支持,以优化药物管理.
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